Healthcare Provider Details

I. General information

NPI: 1770927089
Provider Name (Legal Business Name): TRUE NORTH TREATMENT CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2013
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 N OREM BLVD
OREM UT
84057-6601
US

IV. Provider business mailing address

234 N OREM BLVD
OREM UT
84057-6601
US

V. Phone/Fax

Practice location:
  • Phone: 801-691-0672
  • Fax: 801-691-0673
Mailing address:
  • Phone: 801-691-0672
  • Fax: 801-691-0673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number19375
License Number StateUT

VIII. Authorized Official

Name: MR. JEDEDIAH D. PRICE
Title or Position: MEMBER
Credential:
Phone: 208-390-1084